Wessely psychologises Chemical warfare

I couldn't keep this one to myself when I saw it. Wessely has done some work for the UK military and was their main (or certainly one of their main) Gulf War Illness deniers.

This lovely little paper is interesting, and has some correlations with the CBT School rubbish on ME/CFS. It is basically a political paper, which becomes more obvious towards the end when he makes a reference to the continuing ill health of Gulf war veterans, which he is clearly hinting that they are really suffering from the psychological effects of warfare, or that they are misattributing poor health to their Gulf War service.

In this paper Wessely is not cited as the main writer, though his finger prints and ideology are all over it.

Contributors: EJ undertook the research, analysis of the data, and wrote the paper. IP collected the data. SW helped to design the study and commented on various drafts of the paper. EJ is guarantor. Funding: Economic and Social Research Council and the Ministry of Defence

Conclusions Chronic symptoms and work difficulties maintained beliefs about the potency of chemical weapons. In the period after the war, gas continued to inspire popular revulsion and was associated with a sense of unfairness.]

Recent studies of troops in training or civilians attacked by terrorists have shown that chemical weapons have retained their capacity to frighten.

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[who wouldn't be afraid of chemical weapons?]

During the first world war, fears associated with chemical weapons were disproportionate to their killing power

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[It was the horrific effects of it and not just deaths I think that concerned people. Also these things are deadly if you inhaled enough, so it was hardly abnormal to be worried about them]

Using records from the first world war, when chemical weapons had become an integral part of the main combatants’ armoury, we explored the ideas and beliefs held by servicemen exposed to gas but not seriously incapacitated. To focus on the psychological effects of gassing, we excluded those who had severe disability. It was important to identify a population for whom corroborative evidence existed of exposure but who could be shown through repeated follow-up and mortality data to be essentially healthy.

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[So they tried to pick people who were exposed but deliberately left out people who were worst affected. Talking about loading up your sample (a bit like the way they exclude people with physical signs from CFS diagnosis/studies), and then go on to waffle about abnormal beliefs. And of course if you exlude the sickest it takes the concerns of everyone else out of context and makes them look abnormal for being worried about it.]

We excluded veterans with severe respiratory illness to focus on those whose ideas and beliefs were not grounded in objective pathology directly related to the war. We included pensioners who had occasional or mild episodes of bronchitis because these were recovering conditions that may have been related to other effects such as smoking, industrial pollution, or poor housing.

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[But these people may have had limited/unsatisfactory medical care, so even if there were other possible explanations for conditions they experienced, they may not have been given them. This doesn't mean they have psychological issues]

Repeated follow-ups during the period between the wars enabled us to exclude veterans who had tuberculosis, chronic bronchitis, or emphysema associated with gassing

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[So lets try to exclude all the really sick people as they might mess up the study]

In general, this group of veterans believed that the effects of chemical weapons were irreversible, potent, and debilitating. These conceptions stood in contrast with the objective measures of health recorded for individuals in the sample and general observations made by specialist physicians. This raises the key question, why did these veterans take such a pessimistic view of their health?

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[But they excluded the sickest so the results were a forgone conclusion. Also in some cases the effects of these weapons would be permanent, so it was not irrational or illogical to be concerned about it]

During the war itself, gas was one of the most feared weapons. It inspired emotion out of all proportion to its ability to kill or wound

Recent studies of US veterans exposed to the threat of chemical weapons have shown that both symptoms and the memory of alerts in war zones are important in establishing and maintaining beliefs about being poisoned

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[I remember reading something that US Gulf war vets thought they had been exposed to chemicals in some area during Gulf War 1. The military denied it but eventualy released information that confirmed the veterans beliefs. So one cannot rely entirely on released military data to confirm or deny exposure.]

....We conclude from our war pension data that there was an interaction between ex-servicemens symptoms and beliefs, which began with the traumatic experience of being gassed but was also linked to popular convictions about its potency and systemic effects. The conviction of having been gassed, whether accurate or not, had long term deleterious effects on a persons beliefs about illness and perceptions of health and wellbeing. Our analysis might also assist in understanding the otherwise baffling persistence of ill health experienced by some US and UK military personnel after their deployment to the 1991 Gulf war.

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[As far as I know the US military now accepts at least some Gulf War vets have physical health problems relating to the war, but the last I heard the UK military was sticking to its denial, with Simon Wessely being one of their chief denialists. I don't know if anything has changed since then as I have not been following it.

But this whole article is totally doing the thing Wessely and co do so well, implying that symptoms are either in people's heads, or that the silly patients don't understand where their health problems are coming from]

I kept thinking of this poem as I was reading that article, written by someone who was in the war-zone during World War 1, and who saw the effects first hand. This is a bit graphic/disturbing if you haven't seen it before, so if sensitive maybe skip it (it is about someone getting gased in WW1). I thought it was useful to be reminded of what it was really like, as it is easy to lose site of reality when reading Wessely stuff.

"Dulce et Decorum Est "

by Wilfred Owen (1893-1918)

Bent double, like old beggars under sacks,
Knock-kneed, coughing like hags, we cursed through sludge,
Till on the haunting flares we turned our backs
And towards our distant rest began to trudge.
Men marched asleep. Many had lost their boots
But limped on, blood-shod. All went lame; all blind;
Drunk with fatigue; deaf even to the hoots
Of tired, outstripped Five-Nines that dropped behind.

Gas! GAS! Quick, boys! -- An ecstasy of fumbling,
Fitting the clumsy helmets just in time;
But someone still was yelling out and stumbling
And flound'ring like a man in fire or lime . . .
Dim, through the misty panes and thick green light,
As under I green sea, I saw him drowning.

In all my dreams, before my helpless sight,
He plunges at me, guttering, choking, drowning.

If in some smothering dreams you too could pace
Behind the wagon that we flung him in,
And watch the white eyes writhing in his face,
His hanging face, like a devil's sick of sin;
If you could hear, at every jolt, the blood
Come gargling from the froth-corrupted lungs,
Obscene as cancer, bitter as the cud
Of vile, incurable sores on innocent tongues, --
My friend, you would not tell with such high zest
To children ardent for some desperate glory,
The old lie: Dulce et decorum est
Pro patria mori.

Do you know if Wessely was a consultant for any military organizations (including NATO) when this 'study' was being done? (Don't bother searching if you don't already know; you're probably already three-quarters insane after all this...)

I didn't think it was possible for my estimation of SW to drop any lower, but I believe it just did.

Our analysis might also assist in understanding the otherwise baffling persistence of ill health experienced by some US and UK military personnel after their deployment to the 1991 Gulf war.

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What, after excluding all those with signs of physical illness? How could an analysis of such a group "assist in understanding" those with persistent "ill health"? And who said all those veterans were afraid of gas (which is all they focused on in this study)? And.. so on. This is an example of one of the very common logical flaws in many psychological papers I have seen... drawing inappropriate conclusions and then generalizing them, often into inappropriate associations.

Thanks for the poem, by the way... very powerful, especially as it is so appropriate.

This is actually a topic that I know a bit about. The research lab where I had an internship at (when I got sick) [FONT=Cambria, serif] was part of a group called CounterAct that had secured a $19.2 million grant (Army) for the development of therapeutic countermeasures [/FONT][FONT=Cambria, serif]to chemical terrorism[/FONT][FONT=Cambria, serif].[/FONT] The group I worked had the task of developing countermeasures for the ocular damage that is caused by Sulfur Mustard gas. Though my research focused on the cornea, other nearby labs were working on countermeasures for the skin and lungs. From presentations that I attended, it was clear that many years after being gassed, servicemen continued to experience health problems, sometimes after decades of no symptoms.

This is from a presentation that I did about the lab:

[FONT=Cambria, serif]Severe injury usually heals after several months, although permanent impairment has been documented. One of the most disturbing facts about ocular sulfur mustard exposure is that long after the acute injuries appear to have healed, recurrent or delayed symptoms, including ulceration, inflammation, and corneal erosion may occur (Gordon et al., 2008). In fact, some WWI veterans re-experienced symptoms up to 40 years after their initial injuries (Javadi et al., 2005).[/FONT]

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[FONT=Cambria, serif]And from a chapter that my mentor wrote on the ocular effects of Sulfur Mustard (SM):[/FONT]

Data collected later in WWI and throughout the rest of the 20th century indicates that, if Auld (1918) had seen more cases, he would have concluded that permanent injury to the eye is certainly possible. No one at the time he was reporting his observations could have foreseen the delayed recurrence of eye and skin injuries, nor the downstream neoplastic consequences of exposure to SM. The clinical effects from mustard exposure are related to the concentration and duration of the mustard gas vapor (Derby, 1919; Sidell et al, 1997). Since the vesicating gases persist for a long time, they are effective in extremely low concentrations, provided the victim remains in the contaminated area long enough. As mentioned, severe exposures often take many months to heal, and permanant damage causing blindness is a possible sequela.

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From: Javadi, et. al. 2005, Chronic and Delayed-Onset Mustard Gas Keratitis.
Mustard gas was first produced by Meyer in 1886 and was used initially as a vesicant agent for chemical warfare in World War I by the German army. Only 15 to 20 years after its use were its late-onset, progressively destructive effects recognized. Experience during the Iraq–Iran war proved it to be a lethal agent. Mustard gas has a strong irritating effect on living tissue and induces long-lasting toxic effects. Additionally, its destructive effects are not localized to the site of application; remote cells and tissues also become affected. Animal studies have revealed individualized innate resistance to this agent. The authors’ observations of human exposure confirm other observations, namely that under similar circumstances, individuals are not affected to the same extent; some subjects exhibit increased susceptibility.

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<---- See Wessely, there is your answer. Some people have increased susceptibility to sulfur mustard. These veterans that you reported on do not have false gaseous beliefs. They were injured long-term, with possible delayed recurrence.

And if you haven't seen what kind of damage blistering vesicants can cause:

Hi Dr Yes, Maarten has answered your question. The study was part-funded by the military. I have put that in bold now in the first post as it was easy to miss.

I started remember other bits and pieces after I posted that, about Wessely and comments he made, or connections he had in other areas (other than ME/CFS).

But basically that article is like all the others he is involved in: Stupid patients/plebs/underlings of society, worry too much about their health and about the effects of chemicals and so on. So we in authority must protect the public from themselves and their silly little nonsensical worries, and we must learn to ignore what they say as they are all a bit hysterical, and just carry on as suits us.

Edit: I meant to say, thanks kim for that information. Wessely and co write in such a way that it would be easy to fall for what he is saying, but only if one avoids the actual patients or evidence. Always good to remind onself of the actual evidence.

Front row, furthest to the right Edgar Jones (main author of the paper)

Prof Edgar Jones bio

Professor Edgar Jones MA DPhil PhD FRHistS DipClinPsych
Professor of the History of Medicine and Psychiatry
Programme Leader, MSc in War and Psychiatry
Visiting Fellow, Department of War Studies, King's College London

Activities and Interests
Military psychiatry, Maudsley history, evolution of PTSD, treatment of war syndromes, psychological effects of war on civilians.

I couldn't keep this one to myself when I saw it. Wessely has done some work for the UK military and was their main (or certainly one of their main) Gulf War Illness deniers.

This lovely little paper is interesting, and has some correlations with the CBT School rubbish on ME/CFS. It is basically a political paper, which becomes more obvious towards the end when he makes a reference to the continuing ill health of Gulf war veterans, which he is clearly hinting that they are really suffering from the psychological effects of warfare, or that they are misattributing poor health to their Gulf War service.

In this paper Wessely is not cited as the main writer, though his finger prints and ideology are all over it.

Contributors: EJ undertook the research, analysis of the data, and wrote the paper. IP collected the data. SW helped to design the study and commented on various drafts of the paper. EJ is guarantor. Funding: Economic and Social Research Council and the Ministry of Defence

Here are some quotes from the paper:

[who wouldn't be afraid of chemical weapons?]

[It was the horrific effects of it and not just deaths I think that concerned people. Also these things are deadly if you inhaled enough, so it was hardly abnormal to be worried about them]

[So they tried to pick people who were exposed but deliberately left out people who were worst affected. Talking about loading up your sample (a bit like the way they exclude people with physical signs from CFS diagnosis/studies), and then go on to waffle about abnormal beliefs. And of course if you exlude the sickest it takes the concerns of everyone else out of context and makes them look abnormal for being worried about it.]

[But these people may have had limited/unsatisfactory medical care, so even if there were other possible explanations for conditions they experienced, they may not have been given them. This doesn't mean they have psychological issues]

[So lets try to exclude all the really sick people as they might mess up the study]

[But they excluded the sickest so the results were a forgone conclusion. Also in some cases the effects of these weapons would be permanent, so it was not irrational or illogical to be concerned about it]

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This is classic Orwellian doublespeak. He turns the truth back upon itself and makes it into a lie, and lies into "truth". His behavior is classic doublespeak, too. Exclude all those who exemplify those you are claiming to study, include those who will skew your "results" to completely opposite of the truth and call it "proof".

My grandfather was gassed in WWI and continued to suffer some of the bad affects of it all his life. He had memorized that poem describing those effects and recited it stentorianly. In my childhood, it seemed melodramatic, but I now understand how absolutely horrible it was.

Basically, the lungs are liquified by chemical burning and the victim drowns in his own liquified tissues, while in great pain. A truly hellish invention. Only a sadist like Wessely could call it an overreaction to be appalled and fearful of the effects of gas.

Koan, I had the same thought, except not so wonderfully succinct and fitting.

I imagined him as a toady trying to get as close to wearing those gold braids as he could for one shining moment. It gives a whole new image of "suck up"-- I think that military general might have suction marks on his arm for life.

Orla-- great research and analysis. Thank you so much. In fact the first time I encountered SW was because I was very interested in helping out a family friend who had been in the GW 1. I have written a long list of what happened to him over there, but it's really too upsetting and enraging.

I have lain awake nights thinking of all that SW has to answer for. Not just for people with M.E. and their families, but also for vets and their families. The scope of the damage is just overwhelming.

I can imagine just where the ideas for some of the "educational" literature for VA doctors treating GW vets came from. My family friend would bring stuff back from his doctor visits at the VA, and I was curious enough to look over them.

They felt so similar to what we have read in pamphlets about ourselves. No evidence, of course, but not hard to imagine, since SW was in charge.

One of the hallmark symptoms of Gulf War "Syndrome" is a "fixation (that quote I remember well) on a chemical origin" for one's symptoms. They wouldn't even go so far as to call it an illness. Just "symptoms".

How can you possibly fight this? In both M.E. and GWI, these psychiatrists has made the belief that one's illness is of organic/viral/chemical origin a hallmark symptom itself of the overarching pscyhological state of distorted beliefs.

Distortion is one of the maladaptive thinking patterns outlined in CBT theory. It's like the brain in a vat theory-- it can't be disproven.

I don't think anything that Maarten said was worded too strongly.
Lisette

Lisette -- But, even as he sucked up, he wore clown socks clearly showing a lack of respect for the proceedings. He is so complex.

Mithriel -- Was there not a famous case of a WWI soldier who was executed for desertion although he was suffering from, and had been treated for, what was then called either "shell shock" or "soldier's heart"? And, did the family not want his name cleared but SW spoke for the side wishing to poke a sharp stick into the grave of a long dead man and heap a little indignity on his memory? I must look that up.

Re: Camelford, Was there ever a man so consistently on the side of greed, expediency and nastiness? It's quite a remarkable body of work.

Front row, furthest to the right Edgar Jones (main author of the paper)

Prof Edgar Jones bio

Professor Edgar Jones MA DPhil PhD FRHistS DipClinPsych
Professor of the History of Medicine and Psychiatry
Programme Leader, MSc in War and Psychiatry
Visiting Fellow, Department of War Studies, King's College London

Activities and Interests
Military psychiatry, Maudsley history, evolution of PTSD, treatment of war syndromes, psychological effects of war on civilians.

P.S. Something else: Do NOT underestimate this sadistic creep, not so much because he has real intellectual nous, for he has not (e.g. compared to those who have, like Roger Penrose) but because he has very much power and is the very willing Doberman Pincher of his government, and those living under English law may be sectioned by him or his cronies.

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Yes, it is very unwise to think that he is a moron or that he will be somehow disgraced and destroyed by, for example, the discovery of a causal role for XMRV. He may be a lousy doctor and scientist, but he is obviously a crafty politician, has lodged himself into a position of influence, and has powerful friends.

Lisette:

Distortion is one of the maladaptive thinking patterns outlined in CBT theory. It's like the brain in a vat theory-- it can't be disproven.

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The unfalsifiable nature of many psychological 'hypotheses' and 'theories', especially in the psychosomatic field, ought to be their downfall but instead has given them a major niche in medical practice. They take care of a great many 'incoveniences' for incompetent or uncaring doctors and for cost-cutting medical insurers and governments.

Re: Camelford, Was there ever a man so consistently on the side of greed, expediency and nastiness? It's quite a remarkable body of work.

Mithriel, what you were referring to, I have a few other interesting bits and pieces on this issue. Worth bearing in mind that WW1 was an imperial war (so no real justice or "cause" to it), and the soldiers were treated like expendable cannon fodder. It was truly horrific for the soldiers in combat.

THE decision by the Government to pardon Private Harry Farr and the
other 304 soldiers executed for cowardice and desertion in the First
World War has been attacked by a leading psychiatrist.

Simon Wessely, Professor of Epidemiological and Liaison Psychiatry
at King's College School of Medicine, London, said that the
Government was mistaken to pardon the soldiers 90 years after the
event.

"We should not succumb to the temptation to rewrite history to make
ourselves feel more comfortable about the past," Professor Wessely
said, writing in the Journal of the Royal Society of Medicine.

Professor Wessely, who is also a consultant adviser in psychiatry to
the British Army, says that it was wrong to reject the judgments
made in 1916, when Private Farr, of the West Yorkshire Regiment, was
sentenced to death.

He questions the Government's decision, announced last month, that
it intended to put before Parliament an order for a "statutory group
pardon" for all 305 soldiers executed during the First World War. If
passed by Parliament, the pardon will be included in the Armed
Forces Bill.

In examining the case of Private Farr, regarded as one of the
strongest candidates for a pardon because of the circumstantial
evidence that he was suffering from shell shock when he refused to
return to the front line, Professor Wessely said: "Private Farr had
been sent to hospital [suffering from] shell shock on three
different occasions before refusing to go to his front line on
September 17, 1916. However, shell shock is not the same as post-
traumatic stress disorder as we now understand it."

He added: "We can be sure that on the day in question Private Farr
was in a state of intense fear, but so were all of the men in his
battalion who faced the prospect of going over the top, as indeed
they did the following morning, in an attack in which 150 of 600
were killed or wounded."

Shell shock, Professor Wessely said, was seen by many as "a
convenient medical label to avoid duties on both sides of the
trenches". He agreed that Private Farr's execution had been
tragic. "He was very unlucky, since in nine of ten similar cases,
death sentences were not carried out."

Professor Wessely added that the experts in 1916 were "better placed
than we are to make these terrible judgments about character, mental
breakdown and duty. We should be thankful we do not have to make
those choices".